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Home My WebLink About3001 HARDING WAY - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.cl.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT .lob Address: 3001 HARDING WY Suite: Vicinity: Parcel Number: 14113337 ,4pplicant: BRESLIN, BILL Address: Zoning: Phone: Zip: Owner: OLIVER,MICHAEL R& AMANDA S Address 3001 HARDING W,4Y � Phone: 714 557-9174 COSTA MESA, CA Zip: 92626-2845 Contractor: 21ST CENTURY ROOFING INC Address: 1835 WHITTIER AV UNIT F12 Phone: 800-784-8787 COSTA MESA, CA 2ip: 92627 License: 807430 Arch : Address: Phone: Eng: Address: ISSUED BY: Status: ISSUED Applied: 09/17/2004 Issued: 09/17/2004 Phone: Zip: License: License: SCOPE OF PERMIT REROOF: T/O EXISTING COMP. ROOF, INSTALL 1 LAYER OF 30# FELT & 23 SQR'S OF ELK COMP. SHINGLES. FEE SUMMARY Plan Check: $0.00 Permit: $111.25 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 TotaL• $111.75 SETBACKS � ' � MAINSTRUCTURE Front 0-0 ACCESSORY Front 0-0 PARKING Existinq: 0 NOTES: Calc Valuation: Sa,soo.00 Claim Valuation: Sa,soo.00 �.-� � - - PLANNING & ZONING ' Rear 0- 0 Rear 0- 0 Required: 0 Left 0- 0 Left 0- 0 Propased: 0 Right 0- 0 Right � 0-0 ' NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 1241•92) EXPIRATION: This permfl shall automatically expire and become vold if work is not commenced within 1B0 days, or if work is suspended or abandoned for a period of 1 BO days. INSPECTIONS: In order tor the work authorized under this permit to be considerad legal, such wark must comply with all applicable codes, and all requlred inspectione and tinal approval must be obtainad. Failure to abtain inspactions and tinal approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 � WORKERS' COMPENSA710N DECLARATION: � � � I hereby aNirm under penalty of perjury one ot the following declaratlons: ❑ I heve entl wlll maimain e certiticate of consent to setl-Insure lor workers' compensetlon, es proWdetl for Cy section 3700 oi the LeDor Code, tor the pertormance otL.ie work lor which t�is permit is issued. � ❑ I.have and will maintain workers' compensation insurence, as requiretl by seMion 3700 of the Labor Code, tor Ihe peQortnence of Ihe work for which this permit is issued. /�worke�m nsatlonlnsurence,yam�a��cynum�erare: 3 /�/��D �Q� � � i% Cam P� "� Number: �is secbon need naf be pleted i! (h pertnrt is �eluetl at one huntlred dal(ers ($100) or less J ❑ I certity ihel in the pedormence of ihe work for which Ihis permit is issuo4 I shell not employ eny person in eny manner so as to be9ome subject to ihe workers' �4ompensatlon laws oi Ce ia, a tl ee ihayJ�MNN'y'QQshoutd becq� e sublect to the workers' compensation prowsions of Sectlon 37q0 0l the LabopCotle, I shell lonhwith dOmpl9with ihese provi s. ��'j� / //.. __ _, � / � � /O y �`�IicaM SI neture: s �� -�i� � �r/1 %�....� � �� WARNINO: FAILURE TO SECUR WORKERS' CQMPENSA� VE pE IS UiiA NL4WFU� Aqp gMALL SUBJECT AN EMPLOVER TO CPIMINAL PE LTNA IES AND 9 VIf L FINES UP TOONE HUNDRE� THOUSAND DOLLAPE (5100,000), IN ADOITIqJ TO THE COST OF CAMPENSATION, DAhNGES AS PROVIDED FOR IN SECTION 3]O60F THE LABOR WDE, IMEREST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: m that I am licensetl under provisions ot Chapter 9(commencing with Section 7000) of �ivision 3 of tha Business entl act. LJc. N � Cless�M�_ SigneWre: � Q (' �je; ✓ CONSTRUCTION LENDING AGENCY: ❑ I hereby aXirtn that there is a construction lending agency (or Iha pertormance ol ihe work tor which this permit is issuetl. (Sec. 3097, Civil Code). Lentler'S Name: Lender's Atltlress: Signature: Date: OWNER-BUILUER DECLARATIONS: my license Is in full I hereby eflirm Me� under penelty of perjury ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor ihe tollowing reason (Sec. 7031.5, Business antl Professions Code: Any ciry or coV�ry which requires e permit to consimct, alter, improve, demolish, or repair any swcture, Dnor to its issuence, also requires Ihe applicaN for such pertnit to tile e signed statement thet he or she Is licensetl pursuant to the pwvisions of Ihe Con�rectors License Law (Chapter 9(commendng with Sectlon 7000) oi Division 3 oi the Business end Professlons Code) or that he or sha is exempt therefrom end the besis for the alleged exemption. Any violetion of Sectlon 7031.5 by eny epplicent tor a permit su6ject5 ihe appllcen� �a a civil penalty af not more ihan five hundred dollars ($500).): ❑ I, as owner ol ihe property, or my employees with wages es �heir sole compensatlon, WILL DO TME WORK, end the sWcture Is not Intentletl or oflered Por sale (Sec. 7044, Business and Professions Cotle: The Comractors License Law does not apply to en owner of property who builds or improves thereon, and who tloes such work himselt ar hersalf or ihrough his or her own amployees, provided that suc� improvements are not intended ar offeretl tor sale. If, however, the building or improvement is sold within one Year ol completioq the owner-builder will heve the 6urtlen ol proving that he or she did not build or improve for purpose oi sale.). ' ❑ I, es owner ot the Droperty, em E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the prolect (Sac. 7044, Business and Profeuions Code: The convec�ors License Law tloes not apply to an owner ol pmpeny who builds or improves thereon, end who wntrects lar such project with a wntrector(s) license pursuen� to the Comractors License Laws.). ❑ I em exempt under sec. Business antl Professions Code for this reason: Signature: Date: Owner ID venfietl by driver's license. ❑ Yes ❑ No Drivers License No. Verification of Ownership by (typa at document, i.e. - pmperty tae bill or deed): Eapires: DIViSION OF INDUSTRIAL SAFETV PERMIT CEpTIFICATION: ❑ I hereby certify �hat no excavetion five (5) or more faet in tlepih Into which e person is required to descend, will be made in connection with work euthorized by Ihis permi�, end the� no building simcture, scaHolding, falsework, or demolition or dismantling ihereof, will be more than ihirty-six (36) teel high (Chap. 3.2, Grp 2, Ar12, Sec. 341, Tltle 8, Celifornia Atlminisirative Code). ❑ As ownerbuiltler, I will not employ enyone to do work which would require e permit imm ihe Division ot IntlusMal Safety, es notetl above, unless such person hes e permit Io tlo suth work from Ihe tlivision. Signature: Date: Division ot Indus�rial Safery Permit Number: CERTFICATE OF CtlMPLIANCE AND AUiHORIZATON OF EMAY: I cenify under penelty of perjury Ihat I have read Ihis application and siate that Ihe infortnation given is correct. I egree to comply with ell state laws and ciry ordinances rela�ing to bulltling constmction, and authonze re0resentatives of Ihe City of Coste Mesa to enter upon ihe above-described property tor inspection purposes. I ag�ee not to occupy or allow occupency ot any building authorized by this permit until linel inspection. Legal COOE �, INSPEC(IONTYEE 1616 Fixed Syster� Final Fire Prevention 1268 Pool Spa Final 200 Finel Re-Roo� 201 Flnal BIocWPetaining Wall 202 203 204 Final Faciory Fire Place Finel Slgn Final DemolU�on �g �� .�� \ CODE 1 INSPECTION TYFE 206 Flnal Mechanlcal 208 Final Plumbing 210 Final Electncal 272 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 FinalBuiltling/Occupanry PAIE Itf�9L$ (714) 754-5273 • Fax (�ta) �sa-oess • www.ci.costa-mesa.BUILDING PERMIT JobAddress: $O01 HARDING WY Suite: Vicinity: ParcelNumber: 14113337 a.ppiicant SORGE, DAVE Address: CITY OF COSTA MESA 77 FAIR DRIVE COSTA MESA, CA Owner. OHARA, FUSAKO Address 3001 HARDING WAY Contracror. Address: � Arch : Address: COSTA MESA, CA Zoning: Phone: Zip: 92626 Phone: Zip: 92626 Phone: License: Eng: Address: 77 FAIR DRIVE. COSTA MESA, CA 92626 ISSUED BY: Status: ISSUED Applied: 17/172000 Issued: 17/17/2000 Phone: Phone: Zip: License: License: SCOPE OF PERMIT CONSTRUCT 39 L.F. OF BLOCK WALL PER CITY STANDARD. NO FEE. CITY PROJECT. Plan Check: $0.00 Permit: $0.00 SMIP Res: $0.00 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $0.00 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0-0 PARKING Existina: o NOTES: Rear 0-0 Rear 0-0 Required: 0 FEE SUMMARY PLANNING & ZONING Lek 0- 0 Lek 0- 0 Proposed: 0 Calc Valuation: Claim Valuation Right 0-0 Right 0- 0 $780.00 so.00 NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requiremenis under California statutes and related regulations. (Ord. No. 9248, § 7, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO tlays, or if work is suspended or abandoned �, for a penod of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considerad legal, such work must comply with all epplicable codes, and all required Inspeetions end final approvel must be oblained. Failure to obtain inspections and final approval will result in ihe expiration of this permit. �� FOR INSPECTIONS CALL: (714) 7545828 taaa+e �aroo� WORKERS' COMPENSATION DECLAAATION: � I hereby affirm under penelty of perjury o�a of the tollowing decleretions: ❑ I have entl wlll maintain e cetliPcele of consent to self-Insure tor workers' compensatlon, as proNtled for by section 3700 of the Lebor Code, br t�e peAormance of Ihe work for which t�is permit is issued. ' • • � ❑ I heve antl wlll malntain workers' ctlmpensetlon insurance, es roquiretl by section 3700 of Ihe Labor Code, for �he peAortnance ot Ne work for which Ihis pertnit is Issuetl. My workers' compensation Insurence carner end policy num6er ere: Carrier. poliry Number. (This secfion need nof be completed i/ Ne permit Is velued ef one hundred daflars ($100J or �ess.) ❑ I certity ihet in Ihe pertormance ol t�a work for which ihis permit is issued, I shall not employ eny person in any manner so es to become subject to the workers' compensatlon laws oi Celifomia, a�d agree Ihet II I should become subJect to the workere' compensatlon pravislons of Section 3700 0l the Labar Cotle, I shall forthwith comply with thesa provisions. Applicant SlgnaNre: Date: WARNINO: FAIWPE TO SECURE WORKEPS' ��1PENSATION COVERAGE IS UNLqWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO dJE HUNDRED THOUSANO OOLLARE (5100,000), IN ADOITION TO THE COST OF COMPENSATION, OAMAGES PS PROVIDED FOR IN SECTION 3]W OF THE IABOR CODE, INrEREST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirtn t�et I em licensed under p�o�isions of Chepter 9(commancing with Section 7000) of Divislon 3 ot the Business antl Pmfessions Cade, entl my license is In full torca enA ettect Lic. a Class a Contractofs Signeture: Date: CONSTRUCTION LENOING AGENCV: ❑ I hereby aHirm Ihat thera is a consW��on lending agency br Ihe pedormance ot t�e work tor which t�is pertnit is iuued. (Sec. 3097, Civil Code). Lendefs Name: Lentler's Atltlress: SignaNre: Date: OWNER-BUILDER DECLARA710NS: I hereby eHirtn that under penalty of perjury thet I am E%EMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business end Protessions Code: Any ciry or county which requires a permit to wnstmct, el�er, Improve, demolish, or repair any stmciure, pdor to its issuence, also requires the applicant tor such pertnit b tile e signea statement Ihet he or she �s Ilcensed pursuent to the pravisions of tha Conirectors License Law (ChaD�er 9(commencing with Sectlon 7000) of DlNsbn 3 ot Ne Business end Professions Cotle) or ihat he or sha is exempt therefrom and the basis for Ihe alleged exemption. Any violetion of Section 7031.5 by eny appllcaN for a pertnit subJects the applicant to a civil penalry o� �et more than live huntlretl tlollars ($500).): ❑ I, as owner of Ihe properry, or my Bmployees wlth wages es t�elr sole compensation, WILL DO THE WORK, and the structure is not intendetl or oHeretl for sale (Sec. 7044, Business and Professions CoOe: 7Te Contractors License Law does not apply to an owner of property who builtls or improves thereon, and who d0es such work hlm5elf or herseN or ihrough his or her own employees, provided Ihat such improvements ere not Intende0 ar oHered tor sele. If, however, the builtling or improvement is solA wiihin one year oi rnmpletion, the owneo-builtler will have the burtlen oi proving thet he or she ditl noI build or impmve tor purpose of sala.). ❑ I, es owner ol the property, am EXCLUSIVELY CONTRACTING WI7H LICENSED CONTRACTORS to construct the projBct (Sec. 7044, Business and Prolessions Gode: The contrectors LJcense LaW tloes not apply ro an owner ol property who builds or improves thereon, end who wniracts for such project wlth e contrecbr(s) license pursuant to ihe Contractor5 Vicense Lews.). ❑ I em ezempt untler sec. Signawra: Ownet ID venfietl hy tlrivels liCense. ❑ Ves ❑ No Business and Professions Cotle for this reason: Veriticetion of Ownership by (lype of tlwument, i.e. - properry tax blll or deetl): DriveYs License No. Da�e: Explres: DIVISION OF INDUS7RIAL SAFETV PERMIT CERTIFICA710N: ❑ I hereby cenify that no exwvation live (5) or more feei in tlepih inio which e person Is requiretl to Cescend, will be made in connection wlth work euihorizetl Dy this pertnit, and that no builtling siructure, scaMolding, falsework, or demolition or dismamling thereof, will be more than thirty-six (36) feel hiph. (Chap. 32, Grp 2, Art 2, Sec. 341, TiUe 8, Celitomia Atlministratl�e Code). ❑ A5 owner�builder, I will not emplay enyone to do work which would require a pertnit Irom the DlNsion ot Industnal Sefety, as noted ehove, unless such person hes a permit to do such work Irom the tliNsion. Signeture: Date: � Division ot Industrial Safery Permit Number. CEHTIFlCATE OF COMPLIANCE AND A�OR¢A710N OF EMRY: I certify under penalry of perjury that I have read this application end state Ihet the infortnation given is correct. I egree to comply wit� all state laws entl city ordinances relating ro bullding consiruction, antl auNorize representatives of the Ciy ol Coste Mesa to enter upon ihe ebove-descnbed properry for inspaction purposes. I egree not to acupy or allow occupancy of eny 6uilding authonzed by Ihis permit until finel inspection. SignaNre 01 gal Owner�s) ta \ O/"iCn o 1\ I't Zi �.� And/Or Aut d d Applice t ate CO�E 1, INSPECTONTYVE 1616 Fixetl System Final Fire Prevention 1268 Pool Spe Final 200 Final Re-Raof 201 Finel BIaWRetaining Wall 202 Final Factory Fire Placa 203 Finel Slgn 204 Final Demoli�ion �g, INIli11L5 ZG-U( � �j11 �( INSPELTIONTYVE 206 Final Mechanical 208 Final Plumbing 210 Flnal Electriwl 212 Flnal Fire Prevention 220 Final Planning Approval 222 Final Site 250 Finel Building/OCcupenty P6� I�� a�i f// _ iii �ii / //i i�i a 6" G.V. �,�.. — . . '—T — � =�— — — tG�P.TiON� �—�N �bo� a is,x� N � �_ n.J�__;,,;��- -- _..... � � , �%��__._ �„ . �� _. ::i � �:: ��, , -,:. � �; .. � � `' � �. ,� ��. j; ,�I , �,��a��r��.l. : �'�a<��, t"� ly __ � :�",.l � �! 1-t :1 +.�:2. 1 t _.__ :. . _ .�.��n._.b.,,j,,._ n,::,,_.t:- �� _, T ��: J . . .. � _. .�• {0 � = —= s s � v�� - `� � IL I� �l :� � �� °� . �, � ; ' � ��, �� ,, il � � � ' .., (.: ' �'' �' � ' � i; �E < < �, + ,:. � ,,,;. N ,.,� O k 41�dit � �^ � � '. 0�:��.. _�� / �; . � • � I � :� O ""/" � s16 CU QV E D/�Ti►''��'' -�',' L� = 242° 0o'2Q'; R = 41�. C�Ca• i Lz t6�3.��5 � t1� _�� , � 9z !ayv`-� Io�� N N h r�ppn �� A N � � �� Ut�W< .p - m ^oo N .00? �; o_ � o� -_ � � �� G''i�y °� G•'�ta y�%da �'u�;�� Du<idioa PERMIT PROCESSING CENTER SUBMI�TAL APPLIC�ION t�-�l ProjectAddress: 3001 HARDING WAY Developmen[ Project Number: SUBMITTAL TYPE: ❑ Building ❑ Planning ❑ Electrical O[her Activity Number: Received By: (if apPlicub[e) OFF[CE USE ONLY ❑ Engineering ❑ Grading ❑ Plumbing ❑ Sanitary Dis[ric[ ❑ Sign ❑ Mechanical Suite/[Jnit: ❑ Fire i Description of work to be performed: (p[euse be specific) Coas: �e.�c> 3 9 L F. oF lo f//4yi �� j%yi�K �LOG,� (,�J,4LL PE/t GTJ dF GoS7R �/JESA SaitDi�✓y 7��/iSio,✓ STA�✓DA� DETfiIL . Sq. Footage: Type of Cons[: Valuation: Occupancy Type: Occupant Load: Grading: CuUFill � Owner/Tenant VI 1't'� IL�iT 1' �4a�� Phone No.: Address: ' Suite/Unit City: State: Zip: ApplicantlAgent: Address: City: ArchitecUEng.: Address: City: _ Phone No.: Suite/UniC S[ate: Reg. No. State: CDL#/SS#: _ Zip: Phone No.: Saite/Unit: Zip: _ Contractor: Phone No.: Address: Sui[e/Unit City: Sta[e: Zip: Sta[e License No.: Class Expiration: Workmads Comp. Policy No.: Expiration: Insurance Company: (SEE BACK FOR /TEM/ZED ELECTR/CAL, MECHANlCAL AND PLUMBING) �zsa�>s� 2546-46 (rav.5/99) cubic yds. 25a8-46 (rev.]/B9) CementCopi�90p��onal � Chartael8bck With 1�3/B� Horizontal TOP ol all Fences For Fences 5' or Len Ven. Bars 3/b'" ¢ a� <' -0" O.C. For Fencea Mi9�er Than 5' Ven. Ban 3/8"� a� 32" O.C. � Fill Cells Solid With Grout Where Steel Occurs pnninr<inq S�PeI Shall Conbrm �o SecA�15��9 A.S.�.M. All Steel to be Lapped 24" ot to Cod� NATURALGRADE . TWO ]/8"O BARS CONTINUOUS TOP ' 6 BOTTOM HOQIZSTEEI MUST BE TIEO IN VLACE AT TIME OF TRENCH INSPECTION. TYPICAL 6�� CONCRETE BLOCK FENCE / . n -�-j - D I_�__I +�i 1�—NIDTH � SEE CMn I : BE�OW 0 FOOTING RE�UIREMENTS CHART WIDTH . . I4�� . THICKNESS . . .10�� . DEPTH OF EARTHTOOTH 24�� SPACING OF EARTHTOOTH 12' 14" . 10" 20" I4� BUILDING DIVISION 8" 16" 16' GENERAL- NOTES MOFTAR; p�e pa�f Plasfic Cement, and Thret Parts Sand GROUT; One Pcrt Cemenf TMee anA One Holf Parts S�ond COPiNG: One Port Cement, TAree Parts Sand CONCRETE: Weil M�xed 1:2-I/2:3-I/2 Ma� of 7-I/2 Gollens of Watar Per Sack ol Cement GROVT MAV BE POUREO FpOM TNE TOP OF 7NE FENCE IN LEl�S WHERE STEEL OCCURS. CELlS AND AREASOF MOHIZONTAI REIN FORCEMENT SHALL BE CLEAR, C�EAN 6 FNEE OF A�� MpR(AR OEBRIS, ETC. H C�- C4PTHTCOTH VJ THE HE�GTM 0� FENCE �LOW BOTTOM QF �pGT�NG SCA�E: I/2��= I' 12" 8" 12" 16� • TF�S SKECCH LS FOR WFORMATfONAL PIJRP46F5 • SOL[D WALLS/FFN�S BEIWEIIJ 2'fi' k 6' IN }�IIGGFi1' SHALL ONLY. APPLGM 6 RESPONSBLE FOR PROVIDING BE SETBAIX AT IFASf 10' FROM FRONi PROPERTY llNE. AN ACCURATE RFPR6SFNfA770N OF T}hR PROPERTY IIJ CASE 7HE SHAPE AND SIZE DO NOT O�RRFSPOND '• SO[.m WALIS/FFN�S SHALL NOi HX� Y 6' IN F�IGHC N7Ifi 7HE INFORMA770N PROVmID ON THLS SFffiEI. WI7}IIN lO OF hIE FRONf PROPERlY fAIE (N07 CURB LINE). I�I : t eY C �g � RE9DENfZ 1 _______, \ �� • VERII�Y DSfAN� FItOM NRB 1U PROPERIY LINE AND 9iOW ON PIAN. VERiFIG170N FROM THE QIY5 ENGINEOiING DIVSION 6 REQUIR�. GII. (714) 75453� POR WPORMA170N. � � �ot�cc � i i i � :� i i i � � { t a �� RE40EMfF R(9ppi(I RE90EMfS I 1 1 � I I . ._______ _"....... _.' '."_......' .. __ / .. , � _ � _ _ _ / STREET BLOCK WALL LAYOUT FOR BUILDING PERMIT P�ANNING DIVISION / � DECLARATION OF . iTHORITY FOR AGENTS OF PROPERTY OWNER TO APPLY FOR PERMITS 3001 HARDING WAY Street Address dldg. Permit # This Permit ll 141-133-37 AP Number ! 1. I(we), ��S� K° y��i�" , declare that I am the Owner of Title of the above referenced real property, and that I(we) hereby authorize: �-3y �F � s7� ,,, �,, �,,�-� � s� - so s9 Name Telephone No. 77 �A�a. �n.iJ� Sveet Address c.os�a �t�A ��- 9Z` Z� Ciry State Zip to obtain permits in my behalf, as owner/builder, for �"�S!�� O�l�� at the above referenced property. 2. Should any person become an employee engaged in the improvement of the property, I(we) shall im- mediately provide Worker's Compensation Insurance coverage and cause a certificate of that coverage to be filed with the Building Division of the City of Costa Mesa, as required by State of California laws. 3. As owner/bui�der in fact, I understand and accept that my responsibilities do not transfer to any other per- son, company or corporation. 4. I agree to indemnify and hold the City of Costa Mesa and its employees or officers harmless from any claim resulting in damage or personal injury to myself or any other parties as a result of work authorized by the permits from the City of Costa Mesa. 5. I declare under the penalty of perjury that the foregoing is true and correct. Executed this � U `� day of � — (/�� i ��5-a,t� Printed Name signature �d a d 99- , at Qy��', Califomia. NOTE: This auihorization does not grant authorization to pertorm the work as owner, it solely provides for limited power of attorney to secure this permit in any behalf. '�� 07)9�a6 �Pev. 7/9p • � CITY OF COSTA MESA ' BI/ILDING DIVISION ; , � DEVELOPMENT SERVICES DEPARTMENT MQA_f1O308 J :" �� PERMIT PERMIT NUMBER (714) 754-5273 • Fax (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626 MECHANICAL PERMIT JobAddress: 3001 HARDINGWY Suite Na Vicinity: Parcel Nunmber: 14113337 Appllcant: LACROUX, JERRY Address: owner: Address: Contrector: li �i Address:�> 29 i-.) � %i / ,ty �, �C( � A/ , 1� � , Arch�l,Eng '_ �� Address �� '! � . Status: ISSUED Applied: 0 711 6/1 9 9 8 Issued: 07/16/1998 ' Phone: 714-546-1653� - ��" _', � � Zip: - � ��f , � ; /i//i i', ' , _ KAl'A �HENRY HIDEKICHI� � !=� � - ; / � ��HARDING WAY � / — _ - -. _ - �� . � V " - Phone. - � ^ -- � � � - STA MESA,CA � - -� Zip: 92626 � � � ' - � �/�, .. -. , � tAHAM.BROS INC ��c�� ' �2 Century pi� \:� � ,��%� Phone� 546-1653 - - � STA�MESA, Cq Zip:: 92626 _ �� ; � � t, %� ..License:r248804.�• • � • -- . i� � - � . . �- . `l � � � � .,y � : r _ > �,. � � , ,;. . . ./.-,�:,�'�, Phone: _ . . � �,:: ` - Zip: . , . � � � License: j .... ' SCOPE OF PERMIT� � REPLACE EXSTAIC UNDER 100 BTU. , . , _„ _ ,. _ ,. ,_ - t �` � . � ISSUE�FEE � � fnst FAU <100 k BTU -. � Inst FAU >700 k"BTU � Repair / Alt CoolinglHeat �... Inst I Rep> Recess Wall Htr��\ Refng Sys <100 k BTU; �'" Refrig Sys�>100 k BTU � Gas Piping. �� Factory Fireplace � Hood w/Mech�Exfiaust " VAV Box �.,�-j � � � - FEE SUMMARY +� . - ' 4uentity _.,.' _ - - . - '� ��/-:._ , 522.00 - �� - - - — - - Repair.l'Alt Absorbtion Unit $1325 Repaii / Alt Refrigeration Unit $0.00' Veiitillation System $0.00 0 Evaporati4e Cooler $0.00 0 Commerciallncinerator , 513.25 1 .. Domestic Incinerator - $0.00 0 ' = � � , Compressors / Absorption Systems $0.00 0 '� �' � .. Up to 3 hp! 100 k BTU , �';$0.00 0 ' � �' �� . � � r , . , �, .i 3 To 15 hp / 500 k BTU �$0.00_ ,.0; �=' �' c 15 To 30 hp'/ 1,000 k BTU, =�' ':;.:': ` �$O.00c�O_ � -. �� 30 To�50 hp / 1;750 k BTU . " , Vent Fan / Smgle Duct, ��; -� $O.bO-: 0,�. .. � ;. Over 50 hp / Over,1,750 BTU Appliance Fire Dampers �_ �� Smoke Dampers Inst or Relocate Appl Vent Air Handlers < 10000cfm Air Handlers > 10000cfm Floor Furnace Floor or Suspend Heater . ; $o.tlo'--o� ��-., � . ' ...- �Boileis - . . . , ,� $O.bO-_ 0 � - • . . " ! ; Up to 3 hp � � , ' ��$0.00 b- �� 3 To 15 hp � $O.OQ- '0 ' 15 to 30 hp � - , : _$0.00 " 0 ' - 30 to 50 hp ' �. $O.bO 0 � , � Over 50 hp � � ' . �$0.00 -0 - � � Other Mechaniwl Fee $0.00 0 , Investigation Fee � . . Plan Check Fee Reinspeclion Fee TOTAL CALCULATED FEES COMMENTS / SPECIAL CONDITIONS Quantity $0.00 0 $0.00 0 ' $0.00 0 so.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 548.50 EXPIRATION: This permit shall eutomatically expire and become void Ii work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order (or the work authorized under this permit to be considered legal, such work must compty with afl applicable codes, antl all requlred inepaetlona end tinal epproval must be obtained. Failure to obtain inspections and final approval will resul� in the expiration of ihis parmit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS' COMPENSATION DECLARATIOf7: I here6y effrm untler penalty of perjury one of the following dadaretions: ❑ I �eve end wlll malntain a certificate of consent to self-Insure for workars' compensation, es providetl for by sectlon 3700 of the Lebor Code, for the peAormence of the rk br which ihis pertnit Is Issued. I heva end wlll maintain workers' compensetion insurence, es required by secllon 3700 0l l�e Lebor Code, for the performance of the work for which thls permit Is issued. My workers' co nsation/Insu�r cartle end palicy number ere: Certler. �`( l U42�//(./ PolicyNumber. Nb lD 1G�7'75l (Thls sec0on need not be comp/eted /l the permlt fs ve et one hundred dollars (8100) or less.) ❑ I certity ihet In Ihe perfartnance ot e w for, Ich this permil is issued, I shell not employ any person In eny manner so as to become sub�ect to the workers' compensetlon la alifomia, an egr at shoultl b�come sub�ect lo the workers' compensation pravisions of Sectlon 3700 of the Lebor CoCe, I shell torthwllh comply with se pro sians. '1 ,�,.`L� , I i ApPlicent Slgnel ' Date: �� (�_. WARNING: FAILURE TO CURE WORK RS' COMPENSATION WVE GE IS UNLAWFUL AND SHALL SU&IECT AN EMPLOVER TO CRIMINAL PENALTIES AN� GVIL FlNES UP TO IXJE NUNDRED TMOUSAND DOLLARE 100,000), IN ADDRION TO THE COST OF COMPENSAiION, DAANGES AS PpOVI�ED FOR IN SECiION 3]080F 7HE UBOR CODE, INTEREST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARA710N: I �ereDy eNirm ihet I em licensed force end ettect. Lic. # Contredof5 SIA�e�ur� CONSTHUCTION LENDING AGENCY: at C�apter 9(commencing with Sectlon 7000) of Division 3 of Ihe Business and Professlans Catle, and my Ilcense is in full Class # Date: � ❑ I hereby eHirm thet Ihere is a canstruction lentling egency tor ihe pertortnence of Ihe work for which this permit is Issuad. (Sec. 3097, Civil Cade). Lentlefs Neme: Lendef9 Address: Signeture: Date: OWNER-BUILOER DECLAHATIONS: I hereby efllrtn thet under penelty of per�ury that I am E%EMP7 FROM THE CONTRACTORS LICENSE LAW for the following �easan (Sec. 7031.5, Business end Protessions Cotle: Any ciry or counry which requlres e pertnit to canstruct, elter, improve, demolish, or rapelr eny structure, prior to Its Issuence, elso raquires the epplicant lar such permit ta flle e signed statament that ha or she Is Ilcense0 pursuant to ihe provisions of the Contrectora License Lew (Chapter 9(commencing with Section 7000) ol Dlvislon 3 oi t�e Business flnd Protessions Code) or ihel ha or sha is exempt therefrom and ihe basis ior the elleged exemption. Any Wolatlon of Sedion 7031.5 by any epplicent tor e pertnit sub�ects Ne applicant to e ctivil penalry of not more than frve hundred dollars (5500).): ❑ I, es owner of the pmperry, or my employees with wages as their sole wmpensatlon, WILL DO 7HE WORK, entl the siructure is not intentled or otfered tor sale (Sec. 7044, Busineu an0 Professions Cotle: The Contractors License Law tloes no� appty to an owner oi properry who bullds or improves thereon, and who does such work hlmself or hereelf or t�roug� his or her own employees, prodded that such Improvemen4q are not Intendetl or oNeretl for sale. If, hov.•ever, the building or improvement Is sold within one year of completion, Ihe owner-builder will have the burtlen oi proving that he or she tlid not build or Improve for purpose oi sele.). ❑ I, es owner ol the properry, em EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTOHS lo construct the project (Sec. 7044, Business end Pmtessions Code: The coniractors Licensa Lew tloes not appty to en owner of property who bullds or Improves thereon, entl who contracts for such pmject wtlh e coniractor(s) Iicensa pursuant to the Contrectore License Lews.). ❑ I em e:empt under sec. Slgnature: Owner ID veritied by drivefs license. ❑ Ves ❑ No Business and Pmtessions Code for ihis reason: Vedflcation of Ownerehip by (rype of dxument, I.e. • properry tex bill or daed): DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: Drivefs License Na. Date: Expires: ❑ I hereby certlty that na escavetlan five (5) or more feet in tlapth into which e person Is requlretl to dascend, will ba maCe In connectlon with work authotlzed by this permit, entl thet no Duiltling siructure, scaHolCing,lalsework, or demolitlon or dlsmentling thereoi, will be more then thirty-six (36) feet hlgh. (Chep. 32, Gry 2, Art 2, Sec. 341, Title 8, Celitomia Adminlstrative COCe). ❑ As owner-builtler, I will not employ enyane ta tla wark which woultl raqulre a pertnit irom ihe DlWsion of Intlustrial Sefery, es noted above, unless such person has a pertnit �o do such work from the division. Signatura: Date: DlNsion of Industrial Sefery Permit Number: CERTIFlCATE OF COMPLIANCE AND AUTHOR¢ATON OF EMFiY: I certity under penalry ot per�ury that I have reed this appliwtion antl state that the informetlon given is cortect. I egree to comply with all stete laws end ciry ordinances relating to builtling construdion, end euthonze represeNetives oi the Ciry of Costa Mese lo enter upon Ihe above-descnhed property for ins0ection purposes. I agree not to oaupy or allow occupanq oi any building authonzed by Ihis pertnit until final inspection. COOE I. INSPECTIONTYYE 1616 Fixed System Final Fire Prevention 1288 Pool Spa Final 200 Finel Re-Roof 201 Final Block/Retaining Well 202 203 �� 2asaae Finel Fectory Fire Place Final Sign Finel Demolition ��1�� — �� oate ��$ �j INSPECTIONTYVE 206 Final Mechenical 6 8 20B Final Plumbinp 210 Final ElectAcel 212 220 Final Fire Preventlon Final Planninp Approvel 222 Final SitB 250 Final Building/Occupancy PHOJE�FOOHE55: 3001 HARDING WY' OWNEP'SNAME: TAKATA, HENRY HIDERICHI aoonEss: 3001 HARDING WAY COSTA MESA,CA 92626 719) 850-9191 ABCHIENGINEEB: HEG.NO.: AO�flESS: UNIT: UNIT: PEFMITTEE: NOBEST INC, (719)892-5583 aooecss: 7600 ACACIA ST G.G. CA 92641 LILENSEO CONTHACTOP DECIABATION: I hereby aHirm Iha� 1 am hcens untler pmvisions ol Chap�er 9(commencing wi�h Section ]000) oi Dimsion 3 olihe Business anC Pmiessions Code my Icens in lulltorce an c/irr uf�J ✓� sTaTe uc.: 3 5 9 ! 2 L s: A. ��(¢ / 3"� / � �' ' Slgna�ure'. � ^� � WOHNEflS' COMPENSATION UECLABATION: I here�y aflirm �ha� I �ave a certilicale o� con5eni Io seli-insure or a ceN�icale o� Workers' Comoensation Iqsqapce. o� �c�nj(ie0 covY �nereol (Section 3800. Lab. C). POLILV NO.: 4 U y � ESP. OATE: 1 O I O S� 9 9 COMPANY: STATE COMP. .� Ce�die0 copy is hereby Wmi5�e0. '�d Certi�ied'e y is h wi�p\ the c y Buildmg(n�,�,=,on �� J `� 1 APPlicanr.�l�' L-��1 _ E%EMPTION FBOM WOBRfNS' C�MPENSATION OECIAFRTION: Qhis seclion neeA not be comple�etl i� the permit is br one hunOretl (5700) or less). I cetlify Ihat in �he DeAormance of Ihe work far which Ihis permit is issuee, I shall no� employ any person in any manner so as Io 6ecome subjep Io the Warkers' Compensation Laws,ol Calilorma. � Date: Signature: NOTICE: IL afler making this aeclara�ion, you shoultl hecome SuDle�� o ��e Workers' Compensation pmvisions o� �he Labor Cotle, you must fotlhwiih cam0ly with suc� pmvisions or Ihis permi� shall be deemed revoke0. CONSTHOCTION LENOING AGENCY: I hereby ailirm ihat ��ere is a constmction lentling agency for �he petlormance af Ne woB �or wAich Ihis permit is issued �Senion 3097. Gv. C�. , LENDEfl: RDOFESS: OWNEN BWLUEB OECLAflATIUN: I here�y atlirm I�at I am exempi Irom �he Con�mctors' Stale license Law �or t�e following reason (Section 703L5 Business antl Pm�essional CoOe: Any ci�y at couniy which requires a permi� lo cons�mct, al�er, impmve, demolish, or re0air any StmcNre. prior to i�s issuance, also require5 ihe applicant �ar such permi� lo file a signed s�a�emeni Ihai �elshe is licensetl pursuanuo Ihe pwvisons ot the Comraclors' Staie License Law (Chapter 9(cammencing wi�� Section 7000) o� Division 3 of Ihe Business and Prolessions Caae) or ��a� he/she is exempt iherelwm antl Ne basis br lhe alleged exem0�ion. Nny viola�ion ol Sec�ion 703t5 6y any applican� for a permii sub�ecis Ihe aDPlicant �o a civi� penally oi no� more t�an live hundred Oollars �5500�. I� I, as owner ol the D�oDerty or my emplayees wi�h wages as �heir sole compensalion, will tlo Ihe woB, antl Ihe ❑ slmclureis nalinientled oroilere� brsale (Semion 7044, Business ana Pm�essional CoOe: The Con�raclors' Sia�e License Law aoes no� apPly lo an awner o� a pmpetly who �uilds or improves tAereon, and who does such work himself/hersel� or (hwug� Ais or Aer own emplayees. pmvided Ihat such impmvemenis are nol inientletl or o��ered �or sale. I�. however Ihe building or impmvemeni is sold wi�hin one year ol comple�ion. t�e owner vnll have ��e burtlen ol proving �e/she tlitl no� huila or impmve for ihe purpose of sale). I, as owner ol �he pmpetlY. am exclusrvety canVacting wi�h licensea conVactars ro cons�mct Ihe Dmlect (Sec�ion 7044, 9usiness ❑ antl Pmfessions Code: The Conlraclors' State License Law does not apply �o an owner ol pmperty who 6ui105 or improves ��ereon and w�o conirads lor suc� pmjec�s wiN a conVactar(5) license Du¢uan� Io ihe ConVactors' S�aie License Law). I am aware Iha� pmoi of iheir Warker's Campensation Insurance should be pmvitleU to me. � I am exempt unUer Section: B. 8 P. C. for Ihis reason�. Oate: Ownec I �o hereby cetlily Ihal I am aware oi ane untler5iantl �he requiremenls o� Cahbmia Heal�h antl Satery Code Seclions 25505, 25533, and 2553a an4l�ai I or any fuWre builtling occupant will/will no� (cirde one) need Io camply wi�h saitl stale codes antl �he requiremen�s for a permit lor cons�mciion or moai�ication irom ihe Air Ouali�y Managemen� OisUict. Residen�ial constmction applications are exempi imm 0ese O�o�isions. Oale: ApplicanP. I here�y cerlify ihal I haveread �his application and slaie� Ihe above inf rmalion is correcL I agrer, o comply wiih all ci�y an0 county o�dinances and stalelawsrelatingta �uilding consimclion na h y aul�or represen�atives olil' iryto e uponthe above�mentioneJ �pm eriy br insPe��ion purpotes, � �. �� Si9nalure'. �� s L¢ense or Sociai Securiiy x.� t6dt�46 Wbue-6uilamg�, Green—Cotle Enlorcemem', Canary—qpplicanC Pmk—Revenue: Goltlenroe—Assesmr CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 06G451 PERMIT NO: B 066951 PLAN CHECK NO: N GOVT: Y SUPP; N CONSTRUCTION TYPE: V-5 PERMIT TYPE: STR PURPOSE: NEW JOB DESCRIPTION : CONSTRUCT 6' X 117LF WALL " SEE COMMENTS SQ FT: 117 CLAIM VALUE: 6,000.00 CALC—VALUE: 2,340,00 GROOP OCC: R-3 ! COMMENTS: WALL 6 F�JOTING NOT TO EXTENP BEYOND PROPERTY LINE *�*,�**��***��******��***��c*�+��**��*��r*;�**��u��:*x*��*+�#*�*�*+��***�+�*� �*****� Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT: FT IA7 REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGAT: FT IN PARKING ftEQ: PROV; PARCEL: 14113337 ZNE: R1 REF NO: PLANNING NOTES> 5 LF, 6' HIGH BLOCK WALL ON THE LEFT SIDE PL/ABUTS REAR PL. > IN CONSUNCTION WITH CITY bUS TURNOUT PAOJECT, ��r�+�*i�**�*�*-�*�r��#**�+�x�t****�r******��r��*�******x��r**�r**#��r* *+�-�**i�****x�*�r+r+��*�-*f�# D E V E L C� F M E N T S E R V I C E S R E Q U I R E M E N T S (j ZONING APPROVED BY ��}� DATE: �_ '�_ � `ti BUILDING APFROVED BY : �� DATE: 3. �1 l� APPLICATION ISSUED BY; DATE: � ,��****��***�,�*��,�**��c� �*��**�,�,�� h� q*� ifiEifiFiEifiEitiilEiEiFiriEiEiflEiEifiEiciF3E�E1F9EiEififiE�lc?EiE3f3EififiEfEifiEiFiE3fif9EjEjEK=#1f3EiEiEiEiEiEjEiEifiEiFif3cififaEiEiEif eifiEiE3EjkitiEiE LEGALIZATION:N P E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE � 3MIP/RES GRAUING PERMIT 54.00 � .50 .� SMIP/NON—RES PLAN ISSUE FEE BUZLDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTALS----> 0,00 0.00 0.00 REVENUE DIVISION TOTALS--> COLLECTED: HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE TOTAL PAID DUE �,0� w; ,Q� ,Q� .00 OVER/SHORT: 00 SMIP/TOT GRADZNG PLAN—CHECK iE iF {E iE iE if if iM1 if if iE iF iE iF iF iE ic jE df iR iF iE iE fE iE fP iE iF iF iF iE if iElf iE iE i(� iE iE iE iE if iElE iE iE iE fE 3E if aE iE iE iE iE iE iE iE iE jE �lE if� jf !E if if if iE if if if iE iE iE?E if it� 3E iE I N D I V I D U A L F E E B R E A h D,0�. W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST i� SFR 117 RES—CONCRETE BLOCK WALL / FT. 20,:00 2,340.00 ENP OF FEES ,. � 1-�� -� al 001.;7341-00157341 T OT DATE: 03/17l94 TIItE: 10:11 f' ',� �• CONSTRUCTION ANp PLANNING PC & SPA APPROVALS Permit # Date Inspector pppROVAIS Permit # Date Inspector 7. Temporary Electrical Service or Pole • 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. � � , 53. Steel iieinforcement . 3. Electricai Conduit UtilitY�Undrgrnd. 54. Forms 4. Electricai Conduit-Undrgrnd." 55. Electrical Bonding 5. Steel Reinforcement (( -- Z��Y �/�- 56. Rough Plumbing & Pressure Test 6. Electrical UFER Gmd. 57. APPROVAI TO COVER�GUNITE 7. Footings [Y�7,�'K /' 58. Electrical Conduit-Undrgrnd. [O 8. Foundation �, 59. Gas Pipe, � Und:grnd., Test 9. Water Pipe-Undrgrnd, � ' 60. Backwash Lines, RTrap, � Undrgrnd. . 10. Structural Floor System � � �� 67. APPROVAL TO DECK f 1. Property Sewer tine & House�Cnnnection , - 62. Backwash $� ReceptorFinal � � 72. Sewer Cap ' , . , 63. Neater & VenFPinal 13. Roof Dreins � 64. Plumbing System - Final 74. Rough Plumbing 65. Electricai�Finai � 75. Rough Electrica6Condui2 , 66. Solar SYstem•Finai 76. Rouc�h Electric VJiring 67. Fencing & Access Approvai 17. Rough4Viring Sign 68. APPROVED FOR PLASTERING 18. Rough Elecvicai-T Bar Ceiiing 69. POOUSPA SYSTEMS FINl�L ' � 19. Rough Heating & Air Conditionin4 FIRE DEPT. REQUIREMENT � 20. Rough Factory Fireplace APPROVALS Permit # 27. Ducte, in Structure 70. Underground Hydro , 22. �ucts, Ventilating Il. Product Piping G' Gas ❑ Oil ' r 23. Gas Pipe-Rough & Test 72. Underground Fiuzh � 24. Roof Framing 73. Undergmd. Storage Tank O Gas ❑ Oil 25. floof St�eathing � 74: Overhead Hydro - � 26. T�Bar Ceiling (Structural) & Monocoat 75. Dry Chemicai - 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEfvi FINAL �' 29. Insulation 78. FIRE PREV. FINAL { 30. D�ywall Nailing HEALTH pEPT. REQUIREMENT � 37. Plaster Brown Coat 79. FINAL INSPECTION 32. Electricai Power MeterFi�al 80. FOOD CERTIFICATE ISSUED �'_____�� 33.� Final Efectric - � Notes: � 34. Finai Heating & Air Conditioning -� 35. Final Gas Pipe-Test • 36. Hood or Canopy 37. Final Factory Firepiace � 38. Final Plumbing 39. Water Service-Finai 40. Gas Service-Fina� 41. Sotar pomestic�inal 42. Backflow Preventer 43. Backflow Irrigation ��` 3'Gyy� �� j G��-�'�� l 44. Landscape irripation SYstam 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING L� -(7.i� (Q G�' 4&. FINAIPLANNWG - . 49. Electric Release to Edison .._ � 50. Gas Release to Southern California Gas Co '-" 5L CERTIPICATE QF OCCUPANCY , - No. Date _ • '- ' ' Permit # � 6 �► � I THIS NUti}BFR MUST Ar,COMPANY AI.! INSNF: TiO�•: ;�F.Q�': `TS DIVLSION OP $U�.pING SAFB7Y cm oF oo�r�►+�s�► ��6� ADDITIDWS, G''LC7!^:I`�, 0 � �r�nFCTIONS $HALI' liL' �j.�,,,,��.:;'.'i �li: .. `;,.l�r(.4ii,iEf�7 Arreov$n � � I� 1�� A/1_ Thb eel W pians airo soed�om YUSf Oe Imq m Ois I �Id� Y adawtut m make my p�pK a�eralim m�ne ps�ion hom Ne Divisiai d Btidnp �d Sefery, CdY ol G llie slampsig Ot this pIan an0 � SHALL NOT be Ct 1D b8 an aPD[UYaI 01 lhe vi01tti0R 018rty qOvi5i0n5 01 dtf� Yesa Obina�e and/o� SWte law. . 1Tese D�s ano pe=mit a0 expire by fhrtitation and pecome 9ie ouiMing oi vark u n i commenced � maimametl active 1� wiUtin 180 n.zy;, ui �� .uance. 11tf4DFNtE — i, , .. ;� �/ k.7� ` ,G�'-7�i1 AA � ',\;:L\;d L'cdT. . :J L�+:w DCi'� C,`""J. �pA� /� 7�/� � e�.0 •�+s�. � � �� , I � V � L� � � 11[1f0[MC[ 11LfIDLMC[ 11Li1D[Mtl � � N W � t F i N .. . .. //�l�f� l.l�/�/�'-"" ♦ ' � J� V Lor 2S TRACT �2 2 . . • �A_s:r�� COSTA MESA BUILDING•SAFETY DEPARTMENT P. O. BOX 977 C08TA MEBA. CALIFORNIA For Applieani fo Fill In Complefely TYPE OR PRINT . COSTA MESA CALIFORNIA MALL __ ' '_' ' . �_ ._ .... ADDRE55 ' r�}i n N��o — ciT., Ne�::porti Beach ;,oi�ti. 6-3zz ARCHITECT .. TEI. -=�if.l9: Kol1- -- CITY "' �. ' . sT^TE 61195 T�'- Mi 6-3zz7 LIC. NO. NO. HIZE � I NO. OP BLOG9. OF LOT � Cj � t R R FC. _ new oa wt USE OF � None EXI6TING BLDG SETBACK LIN6 FROM Cexiea OP ern¢ei O� REAR YAR2� � SIDE YARO I LEPT � 2�� I RIGHT V� DESCRIPTION OF WORK NtW I n�IALTFRATIONI IIAOOITION NO. OF p 1 ROOMS U 6TORIES '-IROOF � � ROCK 1 HERCBY ACKNOWL&D68 THAT 1 X�VE READ TH�9 APPLIGTION weiD BTATe THwT THQ ABOVE I8 CORRECi AN� AOREE TO CON- PLY WITH ALL CITY ORDINANCEe �N� BTAT¢ LJ�WB q80ULATINO BUILDINO CONBTfiUCnON. BIGNATURE OF �� , /.� )_� n� / 1 FEE RECEIU,ED � SEP 27 1309 FINANCE DEPT. CITY OF COSTA MESA APPLICATION FOR PERMIT � q f. BUILDING For Office Use Only RECEIPT NO. P[RMIT NO. "� �'a �'SI i . RQ��y ED BY OA RECg IVEO ,I DfTE 18BUED /�L I � �.J'�-!d%StP 2 v �ee. COSTA MESA. CALIFORNIA APPROVED ZONING IONE �f NO. OF �J U8E OP NEW.r/�l d �L �I I PLpNB (� BUILDINO y�/�, � �h L60AL T � � J DB9CR�PTION � � V � L�'� L A. P. NO. VARDS EVES APPROVED ALLOWED (CENTER LIN! 6T.) i FRONT �Q ` FT. IN e ��..� �.,� /_ ... �v FT. �_ IN. Z ` t FT. —^ IN. ��i �fY.f�. DATE �j26/b I Q/ TH8 AMOUNT BXOWN UNDEq VpLUATION 19 FOH THE PURP08E OF ESTFBLI6H�NG A PEqMIT FE8 ONIY. VALUATION � PERMIT FEE $ •�_ / N S l'�j pS�` PLAN CHEGK $ %� �✓ � p OF � TOTAL FEE 4